BackgroundThe objective of this study was to evaluate effect of an Educational intervention on the number Potential Drug-Drug Interactions in the Emergency Hospital.MethodsThe prevalence and structure of Major Drug-Drug Interactions at Emergency care Hospitals of Aktobe, Uralsk, Atyrau cities (Kazakhstan) were studied (pharmacoepidemiological, cross-sectional study). Educational interventions were developed and implemented to improve pharmacotherapy in the Cardiology Department of the Aktobe Emergency Hospital, followed by an assessment of their effect.ResultsThe effect of educational interventions was revealed, which led to a significant decrease in the indicators of drug interactions of the Major Drug-Drug Interactions by 18.2% (OR: 0.45; 95% CI, 0.25-to-0.82) in the cardiological patients of the Emergency Care Hospital of Aktobe city compared to the Regional Cardiology Center of Uralsk.ConclusionThe implementation of educational pharmacotherapy programs decreased the number of clinically significant drug interactions in the Cardiology Department of Emergency Hospitals.

Clinical Therapeutics e72 Volume 39 Number 8S were normal. PSA was very high and the digital rectal examination was suspicious for malignancy. Bone scintigraphy revealed metastatic foci in the pubic bone on the right, and in bilateral sciatica. The computed tomography of the pelvis confirmed the existence of osteoblastic metastatic foci in the right iliac. The prostate biopsy showed the development of an invasive prostate adenocarcinoma with low differentiation and grading according to Gleason 4+3= 7. The result of the test for HER-2neu was negative. Patient was placed in a chemotherapy schedule every three weeks: transtuzumab 375 mg, paclitaxel 200 mg and carboplatin 320 mg, which was planned for 10 cycles but was interrupted after the eighth cycle due to an allergic shock. In April 2005, the patient developed severe urinary retention. PSA and free PSA values had risen and the metastatic bone foci remained unchanged in a new scintigraphy. He was placed under medication with flutamide 250mg TID, alfuzosin 10mg once daily and an injection of leuprorelin acetate 11.25mg every 3 months. After 5 weeks under the above medication the PSA and free PSA level fell and the CA15-3 marker decreased. Discussion: In an attempt to decipher the simultaneous presence of the two tumors in our patient, two theories can be formulated. According to the first one, prostate Ca has a great effect on men of this age anyway, and therefore, it is a random event that the particular patient was also found to suffer from prostate Ca. The second theory implies a direct association between the two malignancies, either through the causative role of steroid hormones, or through common genetic mechanisms.

Consequences of medical drugs use have been a subject of scientific research, both in terms of long-term effect on the gene pool of populations and immediate effects on human health. Drug-drug interactions (DDI) is an important and still insufficiently recognized cause of medical errors and costs for the healthcare system. We have studied the prevalence and structure of DDI in hospitals of West Kazakhstan. We performed a retrospective analysis of pharmacotherapy in a systematic sample of 730 patients with cardiovascular diseases treated in the hospitals of Aktobe, Uralsk, Atyrau cities in 2014. Potentially dangerous DDI were identified using Drug Interaction Checker source (FDA). The prevalence of major and moderate potential DDI and their structure were studied. Associations between DDI and other studied variables were estimated using odds ratios (OR) and chi-squared tests. For all estimates 95 % confidence intervals (CI) were calculated. We found a high prevalence of major and moderate DDI (53,8 (95 % CI 50,9-58,3) % and 88,1 (95 % CI 85,590,3) %, respectively. We found out that 53,8 % of patients were treated with at least one potentially inappropriate combination. The effect of age (OR 1,8, p 0,001, 95 % CI 1,4-2,5) and polypragmasy (OR 6,0, р 0,001, 95 % CI 2,7-13,1) on potentially dangerous DDI were revealed. Adverse drug effects were diagnosed in 4,1 % of patients, they were more frequently observed in patients with more prescriptions (р = 0,001). The most frequent drugs creating a dangerous combination were spironolactone, ACE inhibitors, enoxaparinm sodium, fondaparinux sodium, clopidogrel, potassium chloride, sartana.

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